Short-term outcomes of displaced femoral neck fractures treated with hemiarthroplasty using direct anterior approach

doi:10.3969/j.issn.2095-4344.0111

Abstract

Abstract:

BACKGROUND: Posterolateral approach is the conventional approach which has been used in the treatment of displaced femoral neck fractures treated by hemiarthroplasty. The clinical curative effect of hemiarthroplasty through a direct anterior approach which has gradually developed is still controversial.

OBJECTIVE: To compare the clinical effects of displaced femoral neck fractures treated with hemiarthroplasty using direct anterior approach and posterolateral approach.

METHODS: A total of sixty-five patients with displaced femoral neck fracture were selected between January 2014 and January 2016 and randomly divided into two groups. The two groups were treated with hemiarthroplasty using direct anterior approach (direct anterior approach group) and posterolateral approach (posterolateral approach group) respectively. Intraoperative and postoperative clinical data, preoperative and final follow-up Harris score and complications were observed between the two groups. The health-related quality of patients’ life was evaluated by using the EQ-5D index.

RESULTS AND CONCLUSION: Surgical time, length of incision, intraoperative blood loss and postoperative drainage volume in direct anterior approach group were superior over posterolateral approach group (P < 0.05). No statistical differences were observed in postoperative time in bed and incision healing time between the two groups (P > 0.05). (2) Postoperative pain score in direct anterior approach group was superior over posterolateral approach group at 5-18 months of follow-up (P > 0.05). Harris score was higher in the direct anterior approach group than in the posterolateral approach group (P < 0.05). (3) No significant difference in health-related quality of patients’ life was determined between the two groups (P > 0.05). (4) There were one case with incision swelling in direct anterior approach group, one case with prosthesis dislocation and one case with periprosthetic fracture in posterolateral approach group. Pulmonary embolism or venous thrombosis of the lower extremities was not found in both groups. (5) These results suggest that both direct anterior approach and posterolateral approach can promote the recovery of hip function, and have good early clinical curative effects. Direct anterior approach is superior over posterolateral approach with the advantages of minor trauma and less bleeding, but it requires skilled operation technique.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Femoral Fractures, Arthroplasty, Replacement, Hip, Prosthesis Implantation, Tissue Engineering

CLC Number:

R318

Li Gang, Wang Yue. Short-term outcomes of displaced femoral neck fractures treated with hemiarthroplasty using direct anterior approach [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(7): 1014-1019.

Figures/Tables 5

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